last minute ID

Question 1

Name the four classes of cell wall inhibitors

Answer 1

penicillins
cephalosporins
cabrpenems
glycopeptices

Question 2

What drugs are in the penicillin class? What is the MOA

Answer 2

Benzyl penicillins (penicillin G, penicillin V)
Aminopenicillin (ampicillin, amoxicillin)
Isoxazyolyl penicillin (cloxacillin, methicillin, nafcillin, oxacillin)

All of the above are beta-lactams

Question 3

What is the MOA of penicillins?

Answer 3

Bactericidal

Beta lactam inhibits cell wall synthesis

Question 4

What is special about amox-clav and pip-tazo?

Answer 4

They pair a beta lactam (amoxicillin, piperacillin)

with a beta-lactamase inhibitor (clavulanate, tazobactam)

Some bacteria produce beta-lactamase: this counters that.

Question 5

What is the mechanism of action of cephalosporins?

Answer 5

Bactericidal
Beta lactam inhibits cell wall synthesis
Less susceptible to penicillinases

Question 6

What are the subgroups of cephalosporins?

Answer 6

Generations

1: cephalexin (Keflex), cefazolin (Ancef)
2: cefuroxime, cefprozil
3: cefixime, ceftriaxone
4: cefepime

Question 7

What is the MOA of carbapenems?

Answer 7

Beta lactam inhibits cell wall synthesis

Question 8

What drugs are in the carbapenem class?

Answer 8

imipenem, meropenem, ertapenem

Question 9

What is the MOA of glycopeptides?

Answer 9

glycopeptid sterically inhibits cell wall synthesis

Question 10

What drugs are in the glycopeptide class?

Answer 10

Vancomycin only

Question 11

What Abx classes are protein synthesis inhibitors?

Answer 11

50S ribosome:

• Macrolides
• Lincosamides

30S ribosome:

• Aminoglycosides
• Tetracyclines

Question 12

Which drugs are macrolides?

Answer 12

erythromycin
clarithromycin
azithromycin

Question 13

Which drugs are lincosamides?

Answer 13

clindamycin
chloramphenicol
linezolid

Question 14

Which drugs are aminoglycosides?

Answer 14

gentamycin
tobramycin
amikacin

Question 15

Which drugs are tetracyclines?

Answer 15

tetracycline
minocucline
doxycycline
tigecycline

Question 16

Which drugs are topoisomerase (DNA) inhibitors?

Answer 16

fluoroquinolones:

ciprofloxacin
norfloxacin
ofloxacin

Respiratory:
Levofloxicin
moxifloxacin

Question 17

Which drugs are anti-metabolites?

Answer 17

trimethoprim-sulfamethazole (Septra, Bactrim)

nitrofurantoin

Question 18

Which drugs are anti-mycobacterials?

Answer 18

isoniazid
rifampin
ethambutol
pyrazinamide

Question 19

Name the classes of antifungals

Answer 19

polyenes
- amphociterin B, nystatin
imidazoles
- clotrimazole, miconazole, ketoconazole
triazoles
- fluconazole, itraconazole, voriconazole, posaconazole
allylamines
- terbinafine
echinocandins 
- caspofungin, micafungin, anidulafungin

Question 20

What are the most common causes of acute rhinitis? What antimicrobial should be used?

Answer 20

rhinovirus, coronavirus, influenza, RSV, parainfluenza, adenovirus

None

Question 21

What are the most common causes of pharyngitis? What antimicrobial should be used?

Answer 21

rhinovirus, adenovirus, influenza, parainfluenza, coxsackievirus, coronavirus

None

Question 22

What are the most common causes of strep pharyngitis?

What antimicrobial should be used?

Answer 22

Group A beta-hemolytic streptococcus

Penicillin, then macrolide (eg erythromycin), then cephalosporin (eg cephalexin)

Question 23

What are the most common causes of sinusitis?

What antimicrobial should be used?

Answer 23

S. pneumoniae, H. influenzae, M. catarrhalis, S. aureus

Penicillin, Penicillin/beta-lactamase inhibitor, cephalosporin in kids fluoroquinolone in adults

Question 24

What are the most common causes of bronchitis?

What antimicrobial should be used?

Answer 24

H. influenzae, parainfluenza, coronavirus, rhinovirus, RSV

None

Question 25

What are the most common causes of CAP (outpt w/o comorbidity)? What antimicrobial should be used?

Answer 25

S. pneumoniae, M. pneumoniae, C. pneumoniae Penicillin, or one of the macrolides (-romycin); 2nd line is doxycycline

Question 26

What are the most common causes of CAP (outpt w/ comorbidity)? What antimicrobial should be used?

Answer 26

S. pneumoniae, M. pneumoniae, C. pneumoniae, H. influenzae Beta lactam, plus macrolide or doxy, or -floxacine

Question 27

What are the most common causes of diarrhea? | What antimicrobial should be used?

Answer 27

Enterotoxogenic e. coli, ampylobacter, salmonella, shigella, viruses, protozoa If >3BM/d, fever, blood: fluoroquinolone (-floxacin), or if SE asia azithryomycin

Question 28

What are the most common causes of diarrhea after Abx? | What antimicrobial should be used?

Answer 28

c. diff! mild-mod: metronidazole Severe (WBC>15, Cr >1.5x baseline): vancomycin

Question 29

What are the most common causes of PUD? | What antimicrobial should be used?

Answer 29

H pylori (after NSAIDs) Penicillin + macrolide (clarithromycin), + PPI.

Question 30

What is the treatment for gonorrhea/chlamydia?

Answer 30

ceftriaxone 250mgIM + azithromycin 1g PO | or, doxycycline

Question 31

What are the common skin flora?

Answer 31

Coagulase-negative staphylococci, corynebacterium, C. acnes, Bacillus, S. aureus

Question 32

What are the common oropharyngeal flora?

Answer 32

viridans group steptococci, haemophilus, neisseria, anarobes (peptostreptococcus, bacteroides, veillonella, fusobacterium, actinomyces, prevotella)

Question 33

What are the common small bowel flora?

Answer 33

e. coli, anaerobes (low numbers)

Question 34

What are the common colon flora?

Answer 34

E. coli, Klabsiella, enterobacter, enterococcus, anaerobes (Bacteroides, peptostreptococcus, clostridium)

Question 35

What are the common vaginal flora?

Answer 35

lactobacillus acidophilus, viridans group streptococci, coagulase-negative streptococci, facultative Gram-negative bacilli, anaerobes

Question 36

What are the common gram-positive anaerobic cocci?

Answer 36

peptostreptococcus, C. acnes

Question 37

What are the common gram-positive anaerobic bacilli?

Answer 37

Clostridium - c. difficile - c. tetani - c botulinum - c. perfringens

Question 38

What are the common gram-negative anaerobes?

Answer 38

Only Bacilli bacteroides: B. fragilis

Question 39

What are the common gram-positive aerobic cocci?

Answer 39

Staph (eg aureus) Strep (pneumoniae, pyogenes = GAS, agalactiae = GBS) Enterococcus: e. faecalis

Question 40

What are the common gram-positive aerobic bacilli?

Answer 40

Bacillus: - b. anthracis - listeria - nocardia

Question 41

What are the common gram-negative aerobic bacilli?

Answer 41

``` Enterobacteriaceae - e. coli, salmonella, shigella, campylobacter, yersinia Klebsiella Legionella Pseudomonas Haemophilus (H influenzae) ```

Question 42

What are the common gram-negative aerobic diplococci?

Answer 42

Neisseria (meningiditis, gonorrheae) | Moraxella (catarrhalis)

Question 43

What are the common non-gram stain bacteria?

Answer 43

Acid fast: | Mycobacteria (tuberculosis, leprae, avium complex)

Question 44

What common bacteria are obligate intracellular?

Answer 44

Rickettsiae Chlamydia (trachomatis) Chlamydophila (pneumonia)

Question 45

Which bacteria have no cell wall?

Answer 45

Mycoplasma

Question 46

Which bacteria are spirochetes?

Answer 46

trepnema pallidum

Question 47

Cocci in clusters: what is it?

Answer 47

Staphylococcus

Question 48

Cocci in lines: what is it?

Answer 48

Streptococcus